Military Sexual Trauma Survivor Preferences for Provider Gender and Associations with Mental Health Evaluation Attendance

Abstract

This study seeks to explore the role of preference in provider gender for treatment-seeking, survivors of military sexual trauma (MST) in a Midwestern VHA hospital setting. The subjects were one hundred ninety-seven veterans enrolled in care who endorsed a history of MST and agreed to referral for follow-up care related to concerns associated with their experiences. Patients indicated their preference, if any, for provider gender. Overall, 47.2% of participants requested a female clinician, less than 1% requested a male clinician (this group not further analyzed), and the remainder had no gender preference. Among women, 53.5% requested a female provider in contrast with 29.4% of men. The patient gender difference in provider gender preference was significant with a small-to-medium effect. The rate of attendance at evaluation appointments was 73.6%. Attendance rates were 74.6% and 70.6% for women and men respectively. Requesting a female provider was associated with an 80.2% attendance rate while those indicating no gender preference demonstrated a 67.6% attendance rate. This comparison was statistically significant though the magnitude of the effect was small. Incorporation of a screener for posttraumatic stress disorder symptoms from a screener did not significantly improve the models or interact with gender and provider preferences.The findings of this study clarify gender preferences among those articulating a desire for MST-related care and that articulating a provider gender preference, rather than patient gender, is associated with improved chance of attending scheduled follow-up care. These findings have important policy and clinical implications for the potential role of veteran preference in augmenting liaison to care.

Improving Substance Use Care: Addressing Barriers to Expanding Integrated Treatment Options for Post-9/11 Veterans

“…In a survey of MST survivors, 47 percent requested a female clinician, 1 percent preferred a man, and the remaining expressed no gender preference (Sexton et al, 2020). Within this group, 54 percent of women veterans and 29 percent of men also preferred a female clinician (Sexton et al, 2020). Though preferences are apparent, it should be noted that there is not strong evidence that gender-specific treatment is more or less effective than mixed-gender treatment.…”

“…However, women veterans with MST acknowledged that being in a group with men who had also experienced MST had the potential to be beneficial (Hundt et al, 2015). In a survey of MST survivors, 47 percent requested a female clinician, 1 percent preferred a man, and the remaining expressed no gender preference (Sexton et al, 2020). Within this group, 54 percent of women veterans and 29 percent of men also preferred a female clinician (Sexton et al, 2020).…”

Psychological Harms and Treatment of Sexual Assault and Sexual Harassment in Adults: Systematic and Scoping Reviews to Inform Improved Care for Military Populations

“…Themes and sample quotes or extracts related to the theme are presented in Table 3 .2. 2018;Sexton et al, 2020;Turchik et al, 2013;Turchik et al, 2014;Valentine et al, 2020;Waitzkin et al, 2018;and Wolff and Mills, 2016. 7 These 13 studies are Burns et al, 2014;Cichowski et al, 2019;Farmer et al, 2020;Hahn, Turchik, and Kimerling, 2020;Holland, Rabelo, and Cortina, 2016;McBain, Garneau-Fournier, and Turchik, 2020;Monteith et al, 2020;Murray-Swank, Dausch, and Ehrnstrom, 2018;Sexton et al, 2020;Turchik et al, 2013;Turchik et al, 2014;Waitzkin et al, 2018;and Wolff and Mills, 2016. Themes are presented according to four levels: health system, program, provider, and individual.…”

“…2018;Sexton et al, 2020;Turchik et al, 2013;Turchik et al, 2014;Valentine et al, 2020;Waitzkin et al, 2018;and Wolff and Mills, 2016. 7 These 13 studies are Burns et al, 2014;Cichowski et al, 2019;Farmer et al, 2020;Hahn, Turchik, and Kimerling, 2020;Holland, Rabelo, and Cortina, 2016;McBain, Garneau-Fournier, and Turchik, 2020;Monteith et al, 2020;Murray-Swank, Dausch, and Ehrnstrom, 2018;Sexton et al, 2020;Turchik et al, 2013;Turchik et al, 2014;Waitzkin et al, 2018;and Wolff and Mills, 2016. Themes are presented according to four levels: health system, program, provider, and individual. The primary theme at the health-system level is that negative perceptions and distrust of health systems tended to lead to a reluctance to engage in care-i.e., whether this reluctance was associated with a less-than-welcoming environment for women or concerns around how medical records were stored and shared (Burns et al, 2014;Cichowski et al, 2019;Murray-Swank, Dausch, and Ehrnstrom, 2018;Turchik et al, 2013).…”

“…• Gender provider preferences (Cichowski et al, 2019;McBain, Garneau-Fournier, and Turchik, 2020;Sexton et al, 2020) (Facilitators) • Sensitivity and reactions of providers (Turchik et al, 2013) (Barriers)…”